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Lymphadenitis (Luoli) is caused by blood qi, phlegm, and heat. It invariably originates in the Shaoyang channel. If taboos are not observed, it spreads to the Yangming channel. Generally, it results from rich dietary flavors and accumulated stagnant qi, leading to wind and heat; these are the two main factors that interact and transform. One must distinguish between excess and deficiency patterns. Excess patterns are easy to treat, while deficiency patterns are concerning. This condition belongs to the Gallbladder channel, which governs decision-making, possesses Ministerial Fire, and is characterized by abundant Qi and scarce Blood. In women presenting with this condition, if menstruation occurs on schedule without chills or fever, it is easy to treat; however, if it persists and transforms into tidal fever, it is critical. Unless one abstains from sexual desire and maintains a bland diet, even an immortal could not cure it.

One discussion states: Lymphadenitis corresponds to the "scrofula" (Jiehe) mentioned in classics. When nodules extend from around the ears to the neck and downward to the clavicular fossa (Quepen), they are called Lymphadenitis. When located on the chest or its sides, extending downward to the hypochondrium, they are called "Horse Knife" (Madao). These are governed by the Hand and Foot Shaoyang channels. A solitary, small nodule is called scrofula (Jiehe); a series of connected nodules is called lymphadenitis (Luoli); a long, clam-shaped nodule is called horse knife (Madao).

Another discussion states: Nodules arising around the neck are named "Coiling Snake Goiter" (Panshe Ying); those extending to the chest and connecting to the axilla are named "Melon Vine Goiter" (Guateng Ying); swelling and nodules at the root of the left ear are named "String Bag Goiter" (Chuandai Ying); those at the root of the right ear are named "Honeycomb Goiter" (Fengwo Ying).

Another discussion states: For lymphadenitis and madao appearing around the ears, neck, chest, or axilla, resembling beads, treatment is required whether the skin is intact or ulcerated.

Xiaodu Huajian Decoction (Disinfecting and Hardness-Resolving Decoction)
Danggui (Angelicae Sinensis Radix) - 1 qian
Huangqi (Astragali Membranacei Radix) - 1 qian
Baishao (Paeoniae Radix Alba) - 1 qian
Xuanshen (Scrophulariae Radix) - 6 fen
Tianhuafen (Trichosanthis Radix) - 6 fen
Lianqiao (Forsythiae Fructus) - 1.5 qian
Chaihu (Bupleuri Radix) - 1 qian
Huangqin (Scutellariae Radix) - 5 fen
Niubangzi (Arctii Fructus) - 7 fen
Longdancao (Gentianae Radix et Rhizoma) - 4 fen
Shengma (Cimicifugae Rhizoma) - 7 fen
Jiegeng (Platycodonis Radix) - 1 qian
Chenpi (Citri Reticulatae Pericarpium) - 8 fen
Qianghuo (Notopterygii Rhizoma et Radix) - 7 fen
Bohe (Menthae Haplocalycis Herba) - 4 fen
Haikunbu (Sargassum) - 7 fen
Gancao (Glycyrrhizae Radix et Rhizoma) - 4 fen
Process as coarse powder, one dose, decoct with fresh ginger and take orally.
Alternative prescription: Add Gancaojie (Glycyrrhizae Radix et Rhizoma with nodes), Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Thunbergii Bulbus), and Haizao (Sargassum). This is more effective.

Shengyang Tiaojing Pill (Yang-Raising and Menstruation-Regulating Pill)
Shengma (Cimicifugae Rhizoma) - 8 qian
Gegen (Puerariae Lobatae Radix) - 5 qian
Shaoyao (Paeoniae Radix), stir-baked - 2 qian
Lianqiao (Forsythiae Fructus) - 5 qian
Huanglian (Coptidis Rhizoma) - 5 qian
Huangqin (Scutellariae Radix), wine-fried - 5 qian
Sheng Huangqin (Scutellariae Radix, raw) - 4 qian
Huangbai (Phellodendri Cortex), wine-fried - 5 qian
Jiegeng (Platycodonis Radix) - 5 qian
Guiwei (Angelicae Sinensis Radix, tail end) - 2 qian
Sanleng (Sparganii Rhizoma), wine-fried - 3 qian
Ezhu (Curcumae Rhizoma), wine-fried
Dancao (Gentianae Radix et Rhizoma), wine-rinsed
Gancao (Glycyrrhizae Radix et Rhizoma), honey-fried - 5 qian each
Xiakucao (Prunellae Spica) - 5 qian
Take half the weight of the herbs, grind separately into fine powder. Mix with refined honey to form pills the size of mung beans. Take 120 pills per dose with warm water. The remaining half is used as slices for decoction, 5 qian per dose, decocted in water. Recovery expected within half a month.

One discussion states: For chronic lymphadenitis with flowing deposits causing dual deficiency of blood and qi, emotional depression, poor appetite, limb edema with unchanged skin color, afternoon fever, or non-healing ulcers lasting a long time.

Yiqi Yangrong Decoction (Qi-Nourishing and Blood-Enriching Decoction)
Huangqi (Astragali Membranacei Radix), honey-fried
Renshen (Ginseng Radix)
Baizhu (Atractylodis Macrocephalae Rhizoma), de-rhizome and stir-fried - 1.5 qian each
Danggui (Angelicae Sinensis Radix), wine-washed
Chuanxiong (Ligustici Chuanxiong Rhizoma)
Baishao (Paeoniae Radix Alba), stir-fried
Huai Shengdihuang (Rehmanniae Radix Preparata), stir-fried
Chenpi (Citri Reticulatae Pericarpium)
Xiangfu (Cyperi Rhizoma)
Beimu (Fritillariae Thunbergii Bulbus) - 1 qian each
Chaihu (Bupleuri Radix)
Digupi (Lycii Cortex)
Jiegeng (Platycodonis Radix)
Gancao (Glycyrrhizae Radix et Rhizoma) - 5 fen each
Process as coarse powder, one dose, decoct in water, take after meals. If there is phlegm, add Juhong (Citri Reticulatae Pericarpium Rubrum). If there is stabbing pain under the hypochondrium, add Qingpi (Citri Reticulatae Pericarpium Viride) or Muxiang (Aucklandiae Radix). If there is afternoon fever or slight dizziness, add fried Huangbai (Phellodendri Cortex). If pus is clear, double the dosage of Renshen, Huangqi, and Danggui. If the woman has stagnant qi and chest discomfort, double Xiangfu and Beimu. If menstruation is irregular, add Mudanpi (Moutan Cortex) and Danggui.

One discussion states: Treats lymphadenitis and various tumors.

Yiqi Neixiao Powder (Qi-Suppressing Internal-Dissolving Powder)
Danggui (Angelicae Sinensis Radix)
Chuanxiong (Ligustici Chuanxiong Rhizoma)
Baishao (Paeoniae Radix Alba), stir-fried
Baizhu (Atractylodis Macrocephalae Rhizoma), de-rhizome and stir-fried
Qingpi (Citri Reticulatae Pericarpium Viride)
Baizhi (Angelicae Dahuricae Radix)
Banxia (Pinelliae Rhizoma), ginger-fried
Chenpi (Citri Reticulatae Pericarpium)
Jiegeng (Platycodonis Radix)
Qianghuo (Notopterygii Rhizoma et Radix)
Duhuo (Angelicae Pubescentis Radix)
Nanpo (Magnoliae Officinalis Cortex), ginger-fried
Fangfeng (Saposhnikoviae Radix)
Huangqin (Scutellariae Radix)
Wuyao (Linderae Radix)
Xiangfu (Cyperi Rhizoma)
Binglang (Arecae Semen) - 1 liang each
Suzi (Perillae Fructus) - 1.5 liang
Chenxiang (Aquilariae Lignum Resinatum) - 3 qian
Muxiang (Aucklandiae Radix)
Renshen (Ginseng Radix)
Fengcao (Glycyrrhizae Radix et Rhizoma) - 5 qian each
Process as coarse powder, decoct in water, take warm. Dissipation expected after ten to twelve doses. If it recurs, process according to the dosage into powder, bind with rice paste to form pills the size of wutong seeds. Take 50 pills per dose with wine.

One discussion states: For unruptured lymphadenitis on the left side, use Neixiao Tiaojing San (Internal-Dissolving and Menstruation-Regulating Powder), transmitted by Li Xiling from Shandong.
Shengma (Cimicifugae Rhizoma)
Gegen (Puerariae Lobatae Radix)
Longdancao (Gentianae Radix et Rhizoma)
Huanglian (Coptidis Rhizoma)
Jiegeng (Platycodonis Radix)
Lianqiao (Forsythiae Fructus)
Huangqin (Scutellariae Radix)
Huangbai (Phellodendri Cortex)
Ezhu (Curcumae Rhizoma)
Sanleng (Sparganii Rhizoma)
Gancao (Glycyrrhizae Radix et Rhizoma) - 5 fen each
Dangguiwei (Angelicae Sinensis Radix, tail end)
Baishao (Paeoniae Radix Alba) - 3 fen each
Process as coarse powder, decoct in water, take orally. For slight deficiency, add Xiakucao (Prunellae Spica). For phlegm, add Tianhuafen (Trichosanthis Radix) and Zhimu (Anemarrhenae Rhizoma), 5 fen each. For Shaoyang channel involvement, add Chaihu (Bupleuri Radix), 4 fen.

One discussion states: For madao sores on the right side, unruptured, use Chaihu Tongjing Tang (Bupleurum Channel-Unblocking Decoction).
Chaihu (Bupleuri Radix)
Lianqiao (Forsythiae Fructus)
Guiwei (Angelicae Sinensis Radix, tail end)
Gancao (Glycyrrhizae Radix et Rhizoma)
Huangqin (Scutellariae Radix)
Niuniuzi (Arctii Fructus)
Sanleng (Sparganii Rhizoma)
Jiegeng (Platycodonis Radix) - 2 fen each
Huanglian (Coptidis Rhizoma)
Honghua (Carthami Flos)
Process as coarse powder, one dose, decoct in water, take hot.

One discussion states: For ruptured lymphadenitis.
Buzhong Shengdu Tang (Middle-Supplementing and Toxin-Overcoming Decoction)
Huangqi (Astragali Membranacei Radix) - 1 qian
Renshen (Ginseng Radix)
Danggui (Angelicae Sinensis Radix)
Shengdihuang (Rehmanniae Radix)
Shudihuang (Rehmanniae Radix Preparata)
Baishao (Paeoniae Radix Alba)
Chenpi (Citri Reticulatae Pericarpium) - 3 fen each
Shengma (Cimicifugae Rhizoma) - 5 fen
Chaihu (Bupleuri Radix) - 5 fen
Lianqiao (Forsythiae Fructus) - 1 qian
Fangfeng (Saposhnikoviae Radix)
Gancao (Glycyrrhizae Radix et Rhizoma) - 5 fen each
Process as coarse powder, decoct in water, take hot.

Treatment for lymphadenitis and cervical scrofula, whether swollen or painful: Decoct Xiakucao (Prunellae Spica) in water and take immediately after meals.
Alternative: Use a handful of Xiakucao, decoct in water three times, strain, and boil down to a paste. Apply to the affected area for immediate dissipation.

For lymphadenitis where vital qi is not depleted, use this formula to remove it. If the lesion is removed but does not heal, take the previously mentioned Yiqi Yangrong Tang. If vital qi is weak, tonify first, then take the toxin-clearing formula. After detoxification, continue taking the previous decoction. Assuming no other diseases, this formula dissipates unformed lesions and consolidates ulcerated ones. Suitable for those with strong vital qi. Bixiao San (Extremely Effective Powder)
Nan Pengsha (Borax) - 2.5 qian
Qingfen (Calomelas) - 1 qian
Shexiang (Moschus) - 5 fen
Badou (Crotonis Fructus) - 5 seeds, peel and remove heart
Baibinglang (Arecae Semen) - 1 piece
Banmao (Mylabris) - 40 pieces, remove head and feet, stir-fry with glutinous rice, discard rice
Grind all ingredients into extremely fine powder. Take two eggs, remove yolks, use egg whites to mix the medicine. Place back into the shell, seal with several layers of wet paper, steam in a rice steamer until cooked, dry, and grind into powder. Take 5 fen per dose, mixed with ginger and wine-fried, taken at dawn. If lower abdominal pain occurs, take Yi Yuan San (Beneficial Origin Powder); toxins will be expelled through stool.

Divine prescription for chronic scrofula sores.
Qianchui Lüyun Gao (Thousand-Beaten Green Cloud Ointment)
Songxiang (Pini Resina) - 0.5 jin, melt seven times, filter residue
Ruxiang (Olibanum) - 1.5 qian
Moyao (Myrrha) - 2.5 qian
Xuejie (Sanguis Draconis) - 1 qian
Tonglü (Chalcanthite) - 2.5 qian
Xingren (Armeniacae Semen Amarum), peeled - 2 qian
Haiercha (Camelliae Seed Tea) - 3 fen
Bimazi (Ricini Semen), shelled - 2 liang
Mayou (Sesamum Oil) - 2 liang
Ru zhi (Breast milk) - 2 zhan
Grind into fine powder, mix together with breast milk and sesame oil, stir evenly, beat and pound a thousand times to form ointment. Apply to gauze and place on the affected area.

A woman suffered from lymphadenitis for a long time without healing. Some considered it a Wood-excess syndrome, unsuitable for spring treatment, and pre-treated with Sanzhong Kuijian Tang (Swelling-Dispelling and Hardness-Resolving Decoction), causing increased swelling and hardness. I diagnosed it as Liver channel deficiency and treated with Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang (Middle-Supplementing Qi-Nourishing Decoction). She recovered by spring. If this syndrome is caused by Wind-Fire in the Liver channel itself with no vital qi deficiency, one may use Jianjian Xieqing agents (Hardness-Resolving and Liver-Clearing agents). If the Liver itself is deficient, or Water fails to generate Wood, use Liuwei Wan. If Metal overacts on Wood, one must tonify Spleen Earth and generate Kidney Water. If aggressive purging is used, Spleen and Stomach will be damaged, leading to Wood overacting on Earth.

A woman had swollen and painful neck nodules. Examining her blood and qi deficiency/excess, I first administered one dose of Bixiao San to remove the pathogen, followed by thirty-plus doses of Yiqi Yangrong Tang to tonify, resulting in resolution. Generally, for early-stage lymphadenitis with blood and qi weakness, first use Yiqi Yangrong Tang. Wait until blood and qi are slightly replenished, then use Bixiao San to clear toxins, followed by tonic medicines. This approach is invariably effective. If pus has formed, puncture and tonify/support. If nodules persist despite restored blood and qi, use Jianjian agents (Hardness-Resolving agents). If ineffective and blood/qi remain unchanged, continue with Bixiao San and Yangrong Tang. If still ineffective, moxa Zhoushui (Elbow Tip) and Jianjing (GB21) acupoints, and apply Qianchui Lüyun Gao for self-healing. If blood and qi are robust, spontaneous necrosis may occur without cauterization. Using medication to cauterize facilitates easier consolidation. If blood is deficient and cauterization is used, it is not only useless but leads to failure. Cases involving disregard for diet and emotions are incurable.